Factors associated with presence of ascending aortic atherosclerosis in CABG patients

Background. The indication for epiaortic scanning during coronary artery operation is still a matter of debate. Whether this test should be carried out selectively or on a routine basis is unclear. The aim of this study was to determine factors that predict the presence of atherosclerotic ascending aortic wall thickening in patients undergoing coronary artery bypass grafting (CABG). Methods. A total of 500 CABG patients underwent epiaortic scanning using a high-frequency linear ultrasonic probe. Maximum ascending aortic wall thickness was measured and correlated with patient-related variables. Results. Maximum ascending aortic wall thickness significantly correlated with age (p < 0.001), preoperative creatinine level (p = 0.004), European system for cardiac operative risk evaluation (EuroSCORE, p < 0.001), and maximum descending aortic wall thickness (p < 0.001). Body mass index and left ventricular ejection fraction showed no correlation with maximum ascending aortic wall thickness. Of the categorical variables, hypertension (P = 0.02), unstable angina (p = 0.04), chronic obstructive pulmonary disease (p = 0.02), cerebrovascular disease (p < 0.001), and peripheral vascular disease (p < 0.001) were associated with increased ascending aortic wall thickness whereas sex, diabetes, acute cases, and previous cardiac operation were not. Multivariate analysis revealed maximum descending aortic wall thickness (p < 0.001), cerebrovascular disease (p = 0.03), and peripheral vascular disease (P = 0.04) as independent variables significantly associated with maximum ascending aortic wall thickness. Conclusions. If epiaortic scanning is not carried out routinely for detection of ascending aortic arteriosclerosis it should at least be performed in patients with old age, hypertension, unstable angina, chronic obstructive pulmonary disease, cerebrovascular disease, peripheral vascular disease, elevated creatinine levels, higher EuroSCOREs, and increased wall thickness of the descending aorta. (C) 2004 by The Society of Thoracic Surgeons.